Relation of trihalomethane concentrations in public water supplies to stillbirth and birth weight in three water regions in England.
Relation of trihalomethane concentrations in public water supplies to stillbirth and birth weight in three water regions in England.
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DOI：
10.1289/ehp.7111
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发表时间：
2005-02
影响因子：
10.4
通讯作者：
Elliott P
中科院分区：
文献类型：
--
作者：
Toledano MB;Nieuwenhuijsen MJ;Best N;Whitaker H;Hambly P;de Hoogh C;Fawell J;Jarup L;Elliott P
我们调查了1992-1998年英国三个水域的总三卤甲烷（TTHMs）与死产、低出生体重和极低出生体重风险之间的关系；还研究了与单个三卤甲烷（thm）的关系。对水域中季度TTHM浓度的建模估计，分为低（< 30 μg/L）、中（30 - 59 μg/L）或高（≥60 μg/L），与使用分娩时母亲居住地的约100万例常规分娩和死产记录有关。在一个地区，在暴露类别中存在正的社会经济剥夺梯度，TTHM与死产风险和低出生体重和极低出生体重也存在正的显著关联。使用随机效应模型对三个地区进行总体总结估计，以考虑区域间暴露效应的异质性，结果显示，在TTHM浓度高的地区，死产的超额风险很小[优势比(OR) = 1.11；95%可信区间（CI）， 1.00-1.23)，低出生体重（OR = 1.09; 95% CI, 0.93-1.27）和极低出生体重（OR = 1.05; 95% CI, 0.82-1.34）。在单个thm中，氯仿显示出与TTHM相似的风险模式，但与溴二氯甲烷或总溴化thm的浓度没有关联。我们的研究结果总体上表明，死产与孕产妇居住在高thm暴露地区有显著关联。需要进一步研究特定原因的死产和其他消毒副产物的影响，并帮助区分其他（非因果）解释和可能来自供水的解释。
We investigated the association between total trihalomethanes (TTHMs) and risk of stillbirth and low and very low birth weight in three water regions in England, 1992–1998; associations with individual trihalomethanes (THMs) were also examined. Modeled estimates of quarterly TTHM concentrations in water zones, categorized as low (< 30 μg/L), medium (30–59 μg/L), or high (≥60 μg/L), were linked to approximately 1 million routine birth and stillbirth records using maternal residence at time of birth. In one region, where there was a positive socioeconomic deprivation gradient across exposure categories, there was also a positive, significant association of TTHM with risk of stillbirth and low and very low birth weight. Overall summary estimates across the three regions using a random-effects model to allow for between-region heterogeneity in exposure effects showed small excess risks in areas with high TTHM concentrations for stillbirths [odds ratio (OR) = 1.11; 95% confidence interval (CI), 1.00–1.23), low birth weight (OR = 1.09; 95% CI, 0.93–1.27), and very low birth weight (OR = 1.05; 95% CI, 0.82–1.34). Among the individual THMs, chloroform showed a similar pattern of risk as TTHM, but no association was found with concentrations of bromodichloromethane or total brominated THMs. Our findings overall suggest a significant association of stillbirths with maternal residence in areas with high TTHM exposure. Further work is needed looking at cause-specific stillbirths and effects of other disinfection by-products and to help differentiate between alternative (noncausal) explanations and those that may derive from the water supply.
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影响因子：
5.4
作者：
Dodds, L;King, W;Nimrod, C
通讯作者：
Nimrod, C
影响因子：
5.4
作者：
Gallagher, MD;Nuckols, JR;Savitz, DA
通讯作者：
Savitz, DA
影响因子：
10.4
作者：
King, WD;Dodds, L;Allen, AC
通讯作者：
Allen, AC
影响因子：
5
作者：
BOVE, FJ;FULCOMER, MC;SAVRIN, JE
通讯作者：
SAVRIN, JE
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N